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    rdfs:label "ramipril is an angiotension converting enzyme ace inhibitor indicated for the treatment of hypertension to lower blood pressure lowering blood pressure reduces the risk of fatal and nonfatal cardiovascular events primarily strokes and myocardial infarctions it may be used alone or in combination with thiazide diuretics 1 1 in patients 55 years or older at high risk of developing a major cardiovascular event ramipril is indicated to reduce the risk of myocardial infarction stroke or death from cardiovascular causes 1 2 ramipril is indicated in stable patients who have demonstrated clinical signs of congestive heart failure post myocardial infarction 1 3 ramipril is indicated for the treatment of hypertension to lower blood pressure lowering blood pressure reduces the risk of fatal and nonfatal cardiovascular events primarily strokes and myocardial infarctions these benefits have been seen in controlled trials of antihypertensive drugs from a wide variety of pharmacologic classes including this drug control of high blood pressure should be part of comprehensive cardiovascular risk management including as appropriate lipid control diabetes management antithrombotic therapy smoking cessation exercise and limited sodium intake many patients will require more than one drug to achieve blood pressure goals for specific advice on goals and management see published guidelines such as those of the national high blood pressure education program s joint national committee on prevention detection evaluation and treatment of high blood pressure jnc numerous antihypertensive drugs from a variety of pharmacologic classes and with different mechanisms of action have been shown in randomized controlled trials to reduce cardiovascular morbidity and mortality and it can be concluded that it is blood pressure reduction and not some other pharmacologic property of the drugs that is largely responsible for those benefits the largest and most consistent cardiovascular outcome benefit has been a reduction in the risk of stroke but reductions in myocardial infarction and cardiovascular mortality also have been seen regularly elevated systolic or diastolic pressure causes increased cardiovascular risk and the absolute risk increase per mmhg is greater at higher blood pressures so that even modest reductions of severe hypertension can provide substantial benefit relative risk reduction from blood pressure reduction is similar across populations with varying absolute risk so the absolute benefit is greater in patients who are at higher risk independent of their hypertension for example patients with diabetes or hyperlipidemia and such patients would be expected to benefit from more aggressive treatment to a lower blood pressure goal some antihypertensive drugs have smaller blood pressure effects as monotherapy in black patients and many antihypertensive drugs have additional approved indications and effects e g on angina heart failure or diabetic kidney disease these considerations may guide selection of therapy ramipril may be used alone or in combination with thiazide diuretics ramipril is indicated in patients 55 years or older at high risk of developing a major cardiovascular event because of a history of coronary artery disease stroke peripheral vascular disease or diabetes that is accompanied by at least one other cardiovascular risk factor hypertension elevated total cholesterol levels low hdl levels cigarette smoking or documented microalbuminuria to reduce the risk of myocardial infarction stroke or death from cardiovascular causes ramipril can be used in addition to other needed treatment such as antihypertensive antiplatelet or lipid lowering therapy see clinical studies 14 2 ramipril is indicated in stable patients who have demonstrated clinical signs of congestive heart failure within the first few days after sustaining acute myocardial infarction administration of ramipril to such patients has been shown to decrease the risk of death principally cardiovascular death and to decrease the risks of failure related hospitalization and progression to severe resistant heart failure see clinical studies 14 3" ;
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}